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Health, 10.06.2020 06:57 cityglamevents

Your new job as a front desk receptionist and scheduler at Dr. Grangers’ office is going great! Each day you have learned how to utilize your education on the job. Today you’re learning how to submit a prior authorization request to an insurance company. As you recall from your billing courses at UMA, a prior authorization must be submitted and approved before some procedures can be performed for a patient. Dr Granger has ordered an EKG (electrocardiogram) for Mrs. Brown. Her insurance company requires a prior authorization for this procedure. Your coworker has completed the request form and explained each step to you throughout the process. She has asked you to fax the form to the insurance company. As you look over the form to make sure you understand all the information that is needed to obtain prior authorization you notice the diagnosis listed on the form is sinusitis. You recall the encounter form indicated Mrs. Brown had been seen today because she has developed a sinus infection just two weeks after she experienced a myocardial infarction. Step 2: Create a new thread and answer all three parts of the initial prompt below: Does the diagnosis of sinusitis provide medical necessity for the request for prior authorization to perform an EKG? If yes, why? If no, why not? Describe what action you will take regarding the request for prior authorization for Mrs. Brown. Based on the action you’ve decided to take, explain what you expect the outcome will be.

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